Behind the Mask: Mental Health

The Truth About Anxiety

What makes you anxious? An upcoming math test? A job interview? Asking someone to prom? These feelings usually last anywhere from a few hours to a couple of days. But how would you cope if you felt this way all the time and didn’t know why?

Amanda Aaberg was diagnosed with clinical depression in 2015. She was used to having panic attacks, but this prolonged dysphoria was a new experience for her.

“Back in November, my anxiety started getting really bad for no reason. I got to the point where I had to go to the emergency room about four times before they decided to admit me,” Aaberg said.

But the hospital visits did nothing to calm her down.

“I was just freaking out the entire time,” Aaberg said. “They took away almost everything I used to help myself calm down. I couldn’t watch my favorite YouTubers or shows that usually help calm me down when I feel this way. The only remedies I had left were pacing and drinking ice cold water.”

When she was released, there was only added stress in her life. It was the week of her school play, and Aaberg was a vital member of the crew, making and adjusting costumes for the actors.

“I forced myself to go to the shows, but after that, I stayed home for two months because I could not get myself to go to school. I just felt so bad all of the time,” Aaberg said.

It was not until she was threatened with being kicked out of school and choir that Aaberg finally mustered enough courage to return to school.

“I went back and that was hard. The most difficult thing to do was the choir concert. My freshman year it was fine, but for some reason, ever since my sophomore year it has been increasingly difficult to do concerts. I managed to get through that concert, but it was horrible,” Aaberg said.

The sudden increase in anxiety and depression was a big shock.

“It confused everybody because we didn’t know what had triggered my anxiety. We think it may have been the medication I had been taking – which was supposed to help. I remember going to one doctor who wasn’t listening to anything I said and did. She just kept saying, ‘keep taking the medication, it will work. Just keep taking it,’ but it only made me feel worse,” Aaberg said. “Right now I’m not taking any medication and I’m doing better.”

Aaberg still doesn’t always know what triggers her anxiety or depression.

“If I don’t feel normal, I just go crazy. And it could be any little thing, it’s not just one cause,” Aaberg said.

The most important thing she wants people to know is how to interact and talk to someone with anxiety or clinical depression.

“It’s different for everybody. You might know someone else that has it so you think their remedies are going to work for everyone but that’s not how it works. It’s different for every single person. Just because you may think you know about anxiety and depression, you really don’t. You can’t tell someone, ‘stop freaking out!’ that’s not how it works at all,” Aaberg said.

Anxiety, Depression, and Stress

According to the National Institute of Mental Health, anxiety disorders are the most common mental illness in the U.S., affecting about 40 million people aged 18 and older, which is about 18% of the population. Although these disorders are highly treatable, only one-third of people with these disorders generally receive treatment. Anxiety disorders can develop from many risk factors, including genetics, brain chemistry, personality, and life events. However, some people may experience feelings of anxiety, stress or depression daily, often for no apparent reason. This makes it difficult to carry on with and function in normal, everyday life.

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If I don’t feel normal, I just go crazy. And it could be any little thing, it’s not just one cause.”

— Amanda Aaberg

It is not unusual for someone with anxiety to suffer from depression as well, or the other way around. Nearly half of the people diagnosed with depression are also diagnosed with anxiety.

Depression occurs when a person feels discouraged, sad, hopeless, unmotivated, or disinterested in life. This may be generalized as “the blues,” when feelings last for a short period of time, but if this mental state continues for more than two weeks and the feelings start interfering with daily activities, it is classified as clinical depression.

Localizing the Issue

Teachers and counselors have been seeing an increase in students with these issues in recent years. Colleen Davis, an English teacher, has seen a huge increase in kids with mental health needs.

“Depression is a little harder to see in the classroom, because a lot of the time kids are medicated, but anxiety is more obvious. Most of my students, especially by junior year, are so stressed out and mostly dislike school, even if they are supposed to love it,” Davis said.

Tom Carey, a guidance counselor who has been teaching for 20 years, has also seen a drastic increase in the number of students stopping by his office wanting to talk about their stress or anxiety.

Even though planning for college and the future is incredibly important and can be very stressful, it is everyday stress that has increased the most.

“I think the stress and anxiety that comes with college preparation has always been pretty consistent – having to make a decision about which college to go to, and just the entire application process. It’s a change because, up to this point, high school follows junior high, junior high follows elementary and it’s all very sequential, you don’t have to think about what comes next, you just go with it. Now, a whirlwind of possibilities open up.” Carey said.

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I think how we define ‘special’ might be what’s wrong with the media. People are using those words to describe one person, like only they can be special and achieve that kind of success. I think finding our purpose and meaning, and living that, is where our value is.”

— Tom Carey

This increase in stress and anxiety can also be caused by academic pressure.

“I see a lot of anxiety in a lot of my upper level kids because we’ve added so many AP and honors courses. I think there’s a message that’s being sent that kids should take as many challenging courses as they can and perhaps it’s a bit of an unreasonable expectation, taking 5-7 AP or honors courses in a year,” Davis said.

There is a thin line between motivation and pressure, a line that is easy to cross.

“We want our students to have high expectations,” Carey said. “We need a certain level of stress to do our best, and yet there’s probably a tipping point, too. I think that’s always been a part of the landscape in most Iowa high schools and certainly at City High, since we’re a high school that values education and achievement. There’s a lot more good that comes with that than bad, but you have to watch the tipping point and really take a look at what the endgame is.”

Besides of the academic pressure, Davis has also seen a decrease in students’ desire to learn.

“Kids used to come in and want to learn. They would want to read and learn how to become better writers, and now I feel more of a push from kids,” Davis said. “They would rather only take classes that will help them in their job, so I do feel the shift in how kids perceive education. Before, I feel like kids thought my job was to teach them and prepare them for college, and now I feel like they want to be preparing for a job, and I don’t think those two things are the same.”

Along with academic pressure comes planning for the future, especially college. The increased competition when applying to college puts stress and anxiety on students, believing they have to get straight A’s to get scholarships and get into a prestigious school.

“I don’t know what it is about our society, but I think there’s an idea that you have to go to a really great school to be successful, as opposed to a Big 10 university or starting at community college. People will say to me, ‘I’m just going to Iowa,’ as if there’s something wrong with that,” Davis said.

Millennials and Narcissism

In a study reported on NPR, psychologist Jean Twenge, author of Generation Me and The Narcissism Epidemic says millennials are more likely to claim that they’re “great” and “above average” in their academic achievements, drive to success, and leadership skills. Even though more millennials are receiving straight A’s and beginning to make plans for college and the future sooner, there is no evidence that they are any more productive or educated than previous generations. Many current pop songs, books, acceptance speeches, or other forms of expression are becoming increasingly focused on the individual, promoting messages such as “It’s all about me” and “I’m special.”

“I think how we define ‘special’ might be what’s wrong with the media,” Carey said. “People are using those words to describe one person, like only they can be special and achieve that kind of success. I think finding our purpose and meaning, and living that, is where our value is. That way, everyone can be successful and important. It’s hard to recognize that if you’re not measuring up to the look on a television show or magazine you’re looking at.”

Twenge believes it is widely assumed that children need to have high self-esteem in order to be successful. However, how great someone thinks they are or what they are told does not necessarily correlate with their true value.

“We’re internalizing a different message about what is fame, beauty, importance, or significance, and that’s very hard. I think it’s important that all of us look at what we find meaningful and follow that, and do our best everyday to be who we are, and I think that’s where satisfaction comes from. But I do believe that everyone is unique and special,” Carey said.

Increased self-appreciation does not always lead to happiness or satisfaction. Although teenagers and young adults today are happier, many are more depressed and anxious compared to previous generations. One factor that may have led to this increase is the realization many millennials face in their twenties when everything that was said to them at a younger age about their hopes, dreams, and high expectations for the future don’t match the life they are living. They don’t turn out to be as successful or important as they were told they would be by their parents, icons, or other adults in their life.

“I think that’s probably our culture,” Davis said. “We have shifted to a very child-centered approach to parenting. I think because we understand more about what a child needs and how to nurture them, maybe we have crossed the line in providing proper structure. I struggle with knowing where to draw the line as a parent and as a teacher, knowing when I’m helping them and when I’m indulging them. We want to encourage kids to do well and do their best. I think the best advice I’ve ever gotten about parenting has been: compliment your child on their work, not their intelligence so that they understand that it’s the hard work that is going to be rewarded. I think that’s a difficult concept because we want our kids to feel good.”

Another factor that has changed and affected younger generations is the increased usage and importance of social media. These outlets allow people to view themselves more positively, as the photos and videos posted usually highlight people’s lives and accomplishments.

“There’s a lot of research that talks about how people create who they want to be on social media, and there’s a disconnect between who they are in real life and how they portray themselves, and so it makes sense that more people want to be on social media because that’s the person that they really want to be. There is a gap between reality and illusion,” Davis said. “And it’s not just kids, social media affects everyone. We are all wired to respond to it in a certain way.”

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I think the best advice I’ve ever gotten about parenting has been: compliment your child on their work, not their intelligence so that they understand that it’s the hard work that is going to be rewarded.”

— Colleen Davis

However, social media can make people feel self-conscious, comparing their life to the highlights of someone else’s.

“I think this affects a lot of people, not just students. You see the shining moments of people’s lives on the Internet and when you compare it to where you’re at, you’ll just never match up. That also affects athletes. You may be 50 and looking at the pinnacle of Usain Bolt’s career, but you don’t have to use that standard to be a successful 50 year old. We don’t see everything a person went through to get there. We just see that Facebook moment, not everything that led up to that Facebook moment,” Carey said.

However, social media can be both harmful and beneficial when it comes to stress.

“I think social media is kind of like a paradox, in that kids feel less stressed when they’re on it. They always want to check it because they feel more connected, and when they’re not on it – like during class when they’re not supposed to be on it – there’s a sense of them thinking about it, feeling the pull because they’re so used to being on it all the time,” Davis said. “And when they’re not allowed to, it’s like the song of the siren. It’s something they just can’t resist.”

Fighting Mental Illness

Janice Lane is the Chief Executive Officer of Children and Families of Iowa, an organization in Des Moines that offers services to families and children in crisis. This organization’s mission is to restore hope, build futures, and change the lives of children, parents and families. Lane’s role is very important: she is the face of the organization, working within a variety of service areas such as domestic violence, child care, substance abuse, juvenile justice, and mental health, advocating for the needs of those who cannot advocate for themselves.

Like Carey, Lane believes the prevalence of social media is a critical factor that has contributed to a rise in anxiety.

“I believe the increase in mental health issues is due to the changes in the way we live and how that impacts the experience of growing up. This includes the impact of technology on parent/child relationships, environmental factors, et cetera,” Lane said. “It is essential to remember that the emotional well-being of a child is just as important as their physical health. Helping parents manage the difficult behaviors early in a child’s life may prevent some disorders later in life. This requires time, commitment, continual learning and patience by parents as they interact with their kids. Children can be impacted by the loss of a parent either through death or divorce, movement from schools, states, or neighborhoods, or exposure to trauma.”

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Nothing can replace positive affirmation and supportive communication with parents, educators, and friends. The combination of your social support network often defines who you are and what you do. They accept you unconditionally and are honest in a very supportive and caring way.”

— Janice Lane

The Children and Families of Iowa organization is nearing 130 years of service. The organization has grown vastly since its start in 1888 with only a small group of ministers helping homeless youth. Since then, Children and Families of Iowa has stuck to its goal of providing quality and evidence-based mental health services by licensed clinicians to children and families throughout Iowa. Their mental health services are offered to all clients, using highly trained therapists and clinicians to increase the effectiveness of treatments, making sure services are individualized based on each client’s specific needs.

“Social media, if misused, can be harmful to kids and teens. Cyberbullying has become increasingly problematic due to the prevalence of the Internet,” said Lane. “Youth often receive an unrealistically degrading depiction of themselves through cyberbullying which, unfortunately, can be internalized at a young age. Kids also learn to compare themselves to each other online, even though digital depictions don’t always accurately reflect real life. Consequently, this creates a stressful environment for kids who feel pressured to meet or even surpass unrealistic standards of happiness and success.”

James Burkhalter is the director of the Dialectical Behavior Therapy program at the University of Iowa Hospitals and Clinics, providing individual and group psychotherapy to adolescents and adults who struggle with depression, anxiety, emotional intensity, self-harm, suicidality, eating disorders, and substance abuse. Burkhalter teaches patients how to tolerate strong emotions while making wise choices. One strategy used is mindfulness, increasing awareness of negative emotions including anxiety and depression.

“I believe there is more awareness about children’s mental health issues in these days compared to the past. Today’s youth face a lot more challenges than previous generations. Constant exposure to social media, increased access to various mind-altering substances, and the pressure to be successful are a few of these challenges,” Burkhalter said.

However, Burkhalter disagrees that the pressure comes from false hope kids may be receiving.

“I’m not sure that a child can have too much encouragement,” Burkhalter said. “Most teens who struggle with mental health issues also tend to be invalidated by others. Recognizing and affirming that a person or their feelings or opinions are valid or worthwhile is imperative to one’s well-being, especially to an adolescent.”

Despite the speculation about the role of a parent, teacher, or celebrity, there is widespread agreement that social media is a big factor that impacts the amount of stress, anxiety or depression someone may have.

“I don’t think there is any question that social media can impact one’s mental health. Social media offers unrealistic portrayals of body image, enables an environment of cyberbullying, and makes it difficult for adolescents to have any down time away from social networking. There are certainly some positives of social media, but it can also be extremely detrimental to a teen’s mental health,” Burkhalter said.

Aaberg often finds herself comparing her life and her look to others online.

“I wish I had a life like theirs where I wasn’t like this all the time. I want to get to the point in my life where there is a lot of happiness and good times. I just don’t want to be in hell all the time,” Aaberg said.

That constant comparison also negatively affects Aaberg’s daily life and self-confidence.

“Social media makes it so I have no confidence. I can’t go out and do a lot of things I really want to do like audition for solos or be in plays,” Aaberg said.

Even though there are downsides to social media, there are a lot of positive aspects that have come out of this new method of communication.

“Kids and teenagers are able to connect to peers with a common bond, interest or struggle. Through that function, social media can help establish healthy connections through pre-existing or new relationships,” Lane said.

However, Lane believes the most important relationships stem from a strong support system.

“Nothing can replace positive affirmation and supportive communication with parents, educators, and friends,” Lane said. “The combination of your social support network often defines who you are and what you do. They accept you unconditionally and are honest in a very supportive and caring way.”